Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
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Comparison of Superovulation Outcomes between Short and Long Protocols Using Gonadotropin-Releasing Hormone Agonist in Patients with High Basal Serum Follicle Stimulating Hormone Levels

기초 혈중 Follicle Stimulating Hormone 농도가 높은 체외수정시술 환자의 과배란유도시 Gonadotropin-Releasing Hormone Agonist의 단기투여법과 장기투여법의 비교

  • Kim, Seok-Hyun (Department of Obstetrics and Gynecology, College of Medicine, Seoul National University) ;
  • Song, Eun-Seop (Department of Obstetrics and Gynecology, College of Medicine, Seoul National University) ;
  • Song, Yong-Sang (Department of Obstetrics and Gynecology, College of Medicine, Seoul National University) ;
  • Lee, Kyung-Hee (Department of Obstetrics and Gynecology, College of Medicine, Seoul National University) ;
  • Kim, Jung-Gu (Department of Obstetrics and Gynecology, College of Medicine, Seoul National University) ;
  • Moon, Shin-Yong (Department of Obstetrics and Gynecology, College of Medicine, Seoul National University) ;
  • Lee, Jin-Yong (Department of Obstetrics and Gynecology, College of Medicine, Seoul National University) ;
  • Chang, Yoon-Seok (Department of Obstetrics and Gynecology, College of Medicine, Seoul National University)
  • 김석현 (서울대학교 의과대학 산부인과학교실) ;
  • 송은섭 (서울대학교 의과대학 산부인과학교실) ;
  • 송용상 (서울대학교 의과대학 산부인과학교실) ;
  • 이경희 (서울대학교 의과대학 산부인과학교실) ;
  • 김정구 (서울대학교 의과대학 산부인과학교실) ;
  • 문신용 (서울대학교 의과대학 산부인과학교실) ;
  • 이진용 (서울대학교 의과대학 산부인과학교실) ;
  • 장윤석 (서울대학교 의과대학 산부인과학교실)
  • Published : 1991.12.31
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Abstract

Recently the application of gonadotropin-releasing hormone (GnRH) agonist to superovulation in previous poor responders has resulted in the improved outcomes after in vitro fertilization (IVF) outcome. However, poor responders with poor estradiol $(E_2)$ rise or single dominant follicle are a particularly challenging group. Recent reports have also shown that patients with higher basal serum follicle stimulating hormone (FSH) level, result in poorer ovarian response and lower pregnancy rate. Analysis of the differences of superovulation outcomes according to the different protocols of GnRH agonist, long (L, n = 18) and short (S, n = 16) protocols, in patients with high basal FSH levels (>20mIU/ml) were undertaken at Seoul National University Hospital from June to October 1990. The administration of GnRH agonist was begun on day 21 of the cycle in long protocol, and on day 2 in short protocol. Ages of patients and husbands, basal FSH and luteinizing hormone (LH) levels and FSH/LH ratio did not differ significantly. Types and causes of infertility were evenly distributed. Whereas the duration of stimulation and the amounts of gonadotropins administered were significantly reduced in short protocol, the numbers of oocytes retrieved and cleaved, the cleavage rate and the number of embryos transferred were higher in long protocol without statistical signifieance. The pregnancy rate per ET was 16.7% (2/12) in short protocol, and 17.6% (3/17) in long protocol. These data suggest that both protocols result in the similar superovulation outcomes in patients with higher basal serum FSH levels.

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